Thursday, January 28, 2010

HOPE

Good morning,

After 14 hours from Jacmel to Port-au-Prince, Port-au-Prince to Santo Domingo (and a restless night), we now turn to home.

I peer through the window at my departure gate to see our ride home. I rub my eyes and clearly see that the tail of the aircraft has a Pittsburgh Steelers emblem boldly displayed on it. Being a Dallas Cowboys fan since I was a child this is much to my chagrin. Humorously, it clearly illustrates the fact that some one is trying to send me straight to HELL!!

Maybe it is my brothers of Kappa Alpha Psi Fraternity, Inc., or maybe its my family and friends trying to set up the ultimate episode of MTV's Punk'd. While collectively, I have the greatest set of friends and family a man could have, only they could set the stage like that with a straight face. All of this serving as the usual pool of comic relief I drown myself in daily while at home. Laughter cures all pain.

I want you all to know (friends, family and complete strangers) that you have been a strong support system throughout my journey.

Many positive images have been dancing in my head as I awaited the airport shuttle. My wife's gentle embrace and comforting voice; the smiles, laughter and tears of my two children who have missed me dearly (my wife tells me Dru hugged my pillow two days ago); Me kissing the ground when I arrive in Philadelphia.

Additional thoughts give me a warm heart as well- the Cubans and their evolution of understanding, that while worlds apart we are still the same; the many smiles I have seen along the way; all of the hugs I have received from total strangers.

Two nights ago, 12 little girls appeared on the roadside as we walked back to the hotel in the moonlight. Their ages probably ranged from 4 to 10 years of age.

Believe it or not with wide smiles, they clapped.

You don't have to speak Creole or understand French to perceive and comprehend the universal body language for appreciation.

The "blue shirts" (referring to our scrubs) as we were now known in the town of Jacmel, were doing wonderful things for the Haitian people. We have served as their beacons of hope as the word has spread around town.

In stark contrast to this, I am trying to suppress some of the grim images that I have seen here. Undeniably, they will forever be emblazoned on the walls and storage vaults of my mind. I am fighting tears even as I write this passage. When did I become such a cry baby? Calm, cool, and collected is my usual state but I am still searching for the answers.
All I can say is, I have a heart and two eyes.

I see a man who has lost his wife and two of his seven children to the quake. We provided him with food and one of our six man tents so that he may house his family and "pick up the pieces". He has lost everything. By the way where does one begin?

I see dead bodies piled up in the open spaces and people setting fire to them for disposal while children play double dutch in open fields and lots. Many of them have no parental supervision simply because their parents are dead.

I see the young child with the open thigh wounds and her mother giving her feculent water from a pothole simply because there is no suitable drinking water.

I see people who are complaining of chest pain, not because they have true cardiac disease, but because they have post traumatic stress disorder and are in need of psychiatric care. Their chests weigh heavy from despair.

I see numerous people being kept in living quarters that are not suitable for swine.

I see many sectors of the government that do not function for the people because of greed, corruption, and material gain. Remorse, compassion, humanity, and sympathy do not exist in many instances.

I see a woman that needs an amputation of her foot because there are now flies and maggots in her wounds. She can no longer dress the wound and walk around.

I see mistreatment and injustice for our fellow human beings.

Close your eyes. That is easy to do. For with that action you will make the images go away but for a brief moment.

Instead, I challenge you today to open them wide and pay attention to what is happening around you. I simply made a conscious decision to try and make a difference.

The final image for all of you, which I will never forget, is the ascent of an angel with a tail rotor, headed out to sea. Aboard was two month old Baby Frantz Santius. Mother Haiti's tears of blood have now turned into a river of HOPE.

We are descending into Philadelphia now and as I study the yellow arm bracelet with the impression reading LIVESTRONG on it there is new meaning.

This entry is dedicated to the strong, beautiful and courageous people of Haiti. May God grant you grace.

Respectfully,

Dr. Steven Andrew Johnson
General and Trauma Surgeon,
Surgical Intensivist
Associate Chief, Acute Care Surgical Division
Christiana Hospital
Newark, DE

MIRACLES DO HAPPEN INDEED!!!!!


Teamwork- taking turns monitoring Baby Frantz.
Good Afternoon,

The soft Caribbean breeze is against my skin, the waves forcefully crash against the rocks, the Canadian flag waves proudly from the pole that is centered at the Task Force campground and port of Jacmel. Our team is exhausted.

Anesthesia providers, surgeons, med-peds attendings and an enthusiastic medical student have outlasted their Canadian counterparts. Captain Joiner turns to retire at 200AM in anticipation for meeting tomorrow's challenges. Before she left our presence she removed her helmet and body armor to ask about our tiny patient. For the first time  tears of concern are now visibly rolling down her face as she realizes the power of compassion and the innate ability that this little one is displaying in his quest for survival. The Captain also feels helpless because she does not have the resources to help us evacuate this unfortunate child. This is clearly too much for her to handle and our guardian angel states, "You all are incredible, eh!"




She quietly walks away.

All is quiet now and the heat is taking its toll on all of us. Even at 5:00AM the humidity is sweltering. We had run out of options. Baby Frantz might die in the morning because of our lack of adequate oxygen supply and his continued desaturations and pulmonary dysfunction.


(Pictured Above: The anesthesia machine and even a monitor we were able to salvage from the structurally weakened operating room.)

We were once again dejected and praying for the safety of this child.

But you know what?

MIRACLES DO HAPPEN INDEED!!

At 830AM,  January 27th, 2010, one Colonel Paulette Schank, an anesthesiologist, career soldier and Christian mother of two children who graduated from Abington Senior High School in Pennsylvania (coincidentally, my alma mater) pulled off the impossible.

Out of the sky descended a newly established "angel"- a medivac helicopter from the USS Comfort. While our US military did not have any presence in Jacmel the entire time we were there, they did not abandon us in our time of need. Another sign from Our Heavenly Father and the fact that He is in control. He has NEVER let us down.
Not now and not ever.


Baby Frantz and his parents are now safe as we delivered the Future of Mother Haiti in our makeshift incubator.  In an instant I think of all of my blog entry titles.

Mother Haiti Will Live On.

Enough said.

We are in the Dominican Republic. God grant us safe passage home.


Respectfully,

Dr. Steven A. Johnson
Sent from my Verizon Wireless BlackBerry

Wednesday, January 27, 2010

ONE LAST MIRACLE!!!

Good Morning,

I decided to enter this blog at 1AM because we are in need. Little baby Frantz has been having a tremendous amount of difficulty with his respiratory function. We all believe it is because of something called aspiration. That's where your stomach contents end up in your airway and you have a difficult time breathing. At about midnight baby Frantz began to have a significant drop in his oxygen levels.

This has prompted us to make a tough decision and one that has me searching once again for my guardian angels. After an email and a text message to Major Bouchard, the Canadian Army (at 1135PM) arrived in a Humvee with "wings" and a transport truck with "angel eyes". The assault rifles they carry are intimidating but they are far from that.

Captain Meghan Joiner jumped out of the transport vehicle and informed us that she will grant us our request...yet again. We are running dangerously low on oxygen tanks and the hopes and dreams of Mother Haiti hang in the balance.

I have made the decision (along with my colleagues) to consider transport of this tiny patient to the Jacmel docks where the Canadians have set up tents and medical supplies. Repeated attempts to transport this patient out of here have failed. Without communications and military muscle this child will die.

The scene was surreal. I was in the back of a Humvee holding on so that I didn't fall out. The baby was in a makeshift incubator (a storage box lined with a bunch of our OR drapes and blue towels). His IV was infusing fluid and his oxygen saturations were labile at best.

The Canadians could give us an additional set of oxygen cylinders to almost make it through to the morning. It is 3AM now and my homeward bound transport to Port-au-Prince leaves at 7AM. Our team is not leaving this child and his distraught parents behind.

Even more, no one and I do mean no one wants to fall asleep. We are literally at the Canadian Task Force post taking turns watching the baby and cracking jokes.

Dr. Paula Schank, an anesthesiologist and US Air Force Colonel (who also administering the life saving anesthesia to reporter Bob Woodruff) decided to pull rank and wake up an entire cadre of important ranked officials. She has been granted a delivery from the US Air Force!!! Liquid oxygen tanks that will last much longer and afford us the opportunity to make it to Port-au-Prince by air. The Commanding Medical Officer of the USNS Comfort called her back as well and said that there will be a possible MediVac (helicopter)arrival at 830AM. Importantly, he also offered two
alternative plans should plan A fail.

I am exhausted and we are looking for ONE LAST MIRACLE!!!!

Steve Johnson

Tuesday, January 26, 2010

INVICTUS

Good afternoon,

Today has been a tremendous day for the team. We have worked nonstop for the past 9 hours and we plan on burning the midnight oil. Remember when I told you that failure was not an option? I still feel the same.

News flash !!!! The French government issued a formal, written apology to us on behalf of MSF, the French Doctors Without Borders. MSF "backpedaled" a bit and made it clear that they needed our expertise when it comes to the care of Jacmel's critically ill and injured. Its funny how things can change in 24 hours when people take a look in the mirror or attempt to defend their poor judgement. It is even more reassuring to know that divine intervention is at play during this crisis.

We have been allowed to continue on our mission to save lives and that's all our entire team has ever wanted. "It is not about politics" as our Cuban counterparts pointed out. Instead, we are practicing the art of love and service to humanity, speaking with the universal language of medicine.

My anesthesiologist Roland (aka Dr. Rolando Cubano as he tells me to call him now) informed me today that "the Devil (Castro) has allowed me to collaborate with you". We all rolled on the floor with laughter as the sweat rolled down our brows.

Our day has been even more monumental as Cuban, American, French, Dutch, Canadian, Dominican, Sri Lankan and Haitian have worked side by side in unity.

I have quickly moved on from that sea of bleak emotions that I experienced yesterday and WE are recommitted to focusing on the task at hand.

My time here in Jacmel is drawing
to an end.

The highlight of the day was an operation we performed on a 2 and a half month old who had an incarcerated umbilical hernia.

To explain, the baby has a belly button with a very large protrusion. Within that protrusion the bowel can be compressed and lose its blood flow. This may result in what is called necrosis of the bowel or bowel gangrene, leading to a serious surgical emergency. Thankfully, it was recognized as a "problem" before it became a catastrophic problem. The surgery could not have gone better.

This young child remains on the ventilator here in the operating room. Even more, my colleagues have gone back to the hotel, with the exception of my physician's assistant Scott Stevenson and my pediatrics colleague Dr. Lester Harrell. Two American anesthesiologists from Hopkins and Philly (once again Philly is representin'!! Where is New York??) share the heat as we plan our next move. This young man has had some problems post procedure with respiratory difficulty called pulmonary edema. We have taken measures to try and transport the Future of Mother Haiti to the USNS Comfort in Port-au-Prince. I pray for angels to once again appear but the Canadians, Search and Rescue Service, and the US military are unable to accomodate our requests at this time. Tonight I have volunteered to provide critical care for this baby along with my colleagues. We will transfer the baby from the Cuban tent up to our Camp Delaware (some 900 yards away).

As I watch him breath in unison with the ventilator and I look at the bandage on his abdomen, I have now realized that I have impacted at least one life here.

Thinking about it for a few minutes more, I look around and see new monitors rolling into the Cuban and American operating rooms, new tents being set into place by the Canadian Army, patients smiling, pain being relieved, the hospital director seeking me out to ask questions and saying "good job";the engineers who are surveying the crumpled building that was once called an OR in preparation for repair; more supplies arriving to the tents, Haitian people stopping me to ask if I am Haitian and trying to teach me both Creole and French...I have now arrived at one simple conclusion. A group of caring individuals got together and had the crazy idea of traveling to Haiti during this island nation's time of need. We have literally impacted thousands of lives in the process.

I thank you for your attention and I would like to leave you with a poem very dear to my heart. Probably the only one I still know by heart.

I didn't use this one to impress my wife.

It is by William Ernest Henley.

INVICTUS

Out of the Night that covers me,
Black as a pit from pole to pole. I thank whatever gods may be for my unconquerable soul. In the fell clutch of circumstance, I have not winced or cried aloud. Under the bludgeonings of chance my head is bloody but unbowed. Beyond this place of wrath and tears looms but the horror of the shade, and yet the menace of the years finds and shall find me unafraid. It matters not how straight the gate, how charged with punishment the scroll. I AM THE MASTER OF MY FATE, I AM THE CAPTAIN OF MY SOUL.

Good night. Think of us as we sleep here and take turns monitoring baby Frantz, the Future of Mother Haiti.

This blog entry is dedicated to my brother Kevin who reminded me today that this mission represented the fourth quarter with 30 seconds left and our team was down 21 to 17. Failure is and was NOT an option today.

We have a new US team hitting the ground and replacing us to keep our relief efforts alive.

News Flash!!!! Remember those angels I talked about? Captain Joiner from the Canadian Forces rode up in her truck a few minutes ago and transported us down to the docks where her troops are located. Major Bouchard and the medics provided us with oxygen tanks for Baby Frantz along with a critical care monitor for our care overnight. Angels on my shoulder and divine intervention.

Incredible.

I turn to home tomorrow.


Steve ("Doc J")  Johnson

The Future of Mother Haiti

Monday, January 25, 2010

AMAZING GRACE


Photo courtesy of The News Journal/Suchat Pederson
Good evening,

Today it rained in Mother Haiti. Her tears were representative of the tears I experienced yesterday. The Sun managed to push away the clouds and quickly my spirits were lifted.

Dr. Brebbia and I operated all day hoping to save lives- mission accomplished!!
I must say that I dusted myself off and stood up an 8th time. For you see, failure is not an option for the benefit of the Haitian people.

Bill Withers has a great song called Lovely Day. Instead of entering a long blog post, I am going to let you think about the words and the melody and let pictures tell the story. As Antar Johnson has stated, these pictures illustrate the plight of a people who have suffered for so long and even more during this crisis. Please forgive the graphic nature of these photos.

I will be home soon. I miss my family tremendously.

The Governor is trying to arrange our way home so we don't have to endure the arduous journey that we experienced in getting here. I miss you all. Thank you.

Sincerely,

Doc J


Photo courtesy of The News Journal/Suchat Pederson



Photo courtesy of The News Journal/Suchat Pederson

More Doc J Pics....Warning Some are Graphic


A Sign in Creole Asking for Help


Disclaimer
Doc J asked me to post these pictures some of which I think require a graphic warning. He wanted to share these medical pictures not to sensationalize what he is doing but to educate and give a better appreciation of what he is dealing with on a day to day basis in Haiti. Doc J and his team are doing some great work under very arduous conditions, please keep him and the people of Haiti in your prayers. In order to preserve all intellectual property rights from Photographers/Press or Dr. S. A. Johnson. DO NOT COPY or repost picture from this blog/website without the express written permission.   [Admin- Antar Johnson]



8 month old girl awaits operative debridement of her wound



A four year old girl with tuberculosis and a left neck abscess.
Operated on her today to get rid of her pain and fevers.
Note: the asymmetry in her facial features because of the abscess.



The right thigh wound and the "water"- baby Agaella's plight


This is an amputation of an arm our team worked on.
She was pinned beneath the rubble after a concrete barrier fell.
Her husband pulled her free. We had to complete her amputation.

A Haitian womans foot prior to our amputation. Ironically this
poor woman's foot condition was NOT a result of the quake.

Sunday, January 24, 2010

EXHAUSTION, ANGER and DISAPPOINTMENT- BUT STILL I RISE!!!!

Good evening,

Let me begin by saying I am very sorry for all of the run-on sentences and typos I entered yesterday. I didn't realize just how exhausted I was. My night was restful and I awakened to the sounds of voices speaking Creole in melodic harmony.

Roland met me this morning with his usual Cuban pride. I granted him his wish. Remember, the scrub caps I talked about? I gave him caps with logos from the Florida State Seminoles, Tennesee Volunteers, and the Indiana Hoosiers. He was ecstatic. He had me write down all of my information for future contact. He even stated in front of our respective colleagues, "God Bless America!!!". I pulled Roland to the side and quietly asked him if he was abusing his anesthesia medication. A Cuban saying something positive about America? I have learned that our photographer captured that moment. Roland simply gave me in return that Santa Claus laugh as is typical of his personality. He told me of his day's schedule and we both went on to start the day's work.

The world is filled with evil people, triumphs and tragedies, victories and defeats. Today Mother Haiti and I experienced both first hand. I started off the day by seeing a pediatric consult from my colleagues.

8 month old Agaella, (pronounced A-gale-a), was brought in by her mother to have the baby's wound checked. Baby Agaella had been seriously wounded during the quake with a very large right thigh laceration down to her precious bone. She had been seen during the acute phase of the initial earthquake and had her wounds washed out and partially closed. Unfortunately, today she presented with pus coming from her wounds.

"Darlene, what have you been washing the wounds with?" the translator inquires.

"Doctor, I used water" she replies. "From where?" I asked.
"From the street."
Puzzled I look at the translator. My eyes demonstrated confusion and inquiry as to whether or not something was lost in translation. The translator asks her a question in Creole again. I now realize that the water she speaks of is the same water found in the potholes on the city streets that are filled with bacteria-laden mud deposits associated with the night's rain. "What have you fed the baby?"

"The water," as she peers at me.

That same water that pigs, chickens, and people tredge through each day. I dropped everything and ran back to the hotel (through the streets with the children running beside me cheering and filled with joy). I gather Enfamil and bottles, diapers and a can opener). I return to hand it to Ms. Shaw and her baby.

"Merci!!"

EXHAUSTION- from the deplorable living conditions and the visual images of my wife and I feeding our children the "water".

I continued to operate today, four additional life saving procedures and feeling like I am making a difference only to have my elation and adrenaline rush marred by a dark feeling. For you see, Haiti is filled with politics.

The Medical Director of St. Michel Hospital who has been useless at best, asked to meet with my team and an organization from France (The French version of Doctors Without Borders). As a background, please familiarize yourself with Papa and Baby Doc and the brutalization of the Haitian people.

The French representatives spoke of long terms plans, suboptimal conditions and the needs of the people. Without turning to politics, the irony of this meeting made my blood boil. They informed me that the short term plans once they were up and running did not include my team.

All kinds of emotions floated through my mind. The most prominent of them was ANGER!! I defended my team's efforts and the Miracle created on Jacmel Street (our operating room arising from the ashes). My colleagues clearly saw the emotion I had today as we were less than politely asked to suspend operations.

I have been supported by my colleagues- they assure me that I have made a difference. I know that I have but my desire to preserve life and the compassion for my brothers and sisters comes out as tears today. My feeling today is what Haiti feels every day. Only this country's tears are made of blood.

I am not defeated just fallen. As I tell my children... "If you fall down seven times, always stand up eight." Tomorrow, they are going to have to throw me out. My team plans on conducting business as usual. The Jacmel Mayor is supportive of us.

There is nothing but chaos here- I hope to combat some of it again with a new day. Word came to me that the Swiss heard of our "problem" and are willing to provide a portable operating room they shipped in today. This would be their contribution and our blessing. I do not want to feel an additional emotion- DISAPPOINTMENT.

This evening we traveled to "Tent City". This is an area in the center of town where many casted Coleman tents and sought refuge during the quake. My colleagues convinced me that I would feel better if I saw patients and assessed wounds at one of the tables we used in this makeshift clinic. We evaluated over 300 people tonight and I was present during the assessment of many. Another way to contribute and some satisfaction for me. It was horrific though. 13 year olds with vaginal discharge from unprotected sex, mothers and fathers with hypertension and diabetes, cancer patients with a need for pain control, traumatic wounds (mentally and physically). Haiti will continue with despair and woe until Justice prevails.

BUT STILL I RISE!!! Tomorrow will come if I am granted life for another day. I promise to live it to the fullest acting as the voice for those who cannot speak for themselves. Thanks for your attention.

Special Thanks to my wife and children and to all the old and new (i.e. Doug Grannan, Shirley (aka Otis' wife), and others). I would like to respond to all of you individually but I am time limited. I appreciate you all and one day we will talk about this tragedy.

Much Love,
Doc J

Doc J Pics


Our OR team with a Haitian nurse.


One of our first treated. Wound is a result of falling debris that opened her wound. Her tendons are exposed.which will lead to hand deformity.


French Search and Rescue team that pulled a 21 day old infant from the rubble. They are disappointed that they must return home.
 

Sri Lankan UN forces.

Saturday, January 23, 2010

AND THEN THERE WAS LIGHT!!!!

In order to preserve all intellectual property rights from Photographers/Press or Dr. S. A. Johnson.
DO NOT COPY or repost picture from this blog/website without the express written permission.




Courtesy of The News Journal/Suchat Pederson

Good evening all,

I first want to start out by saying "Merci Beau Coup" for all of the kind words, well wishes and insightful thoughts. Today was a good day like Ice Cube's old school hit that we bobbed our heads too and felt good about.

Our day started with the best oatmeal I have ever had in life!! Cinnamon flavored and melting in your mouth. The Haitian woman who has prepared the breakfast only snickers at me as I inhaled two bowls in
front of her. I haven't eaten much because of my excitement and committment to working tirelessly. Not to mention the 90 degree heat. Last night I left you with frustration and exhaustion. Today I speak to you with much more encouragement and elation.


My Cuban Brothers - Photo courtesy of The News Journal/Suchat Pederson

At 7AM we arrived at Saint Michael Hospital here in Jacmel, Haiti.Our entire team met up with physicians from Inova Fairfax Hospital in VA and began to triage patients and provide the optimal care for them. As I approached the outdoor corridor to begin to try to once again establish an operating room. I was greeted by Roland, the funny Cuban anesthesiologist from Cuba. He pulled me to the side and asked for my Florida State Seminole scrub cap. For those of you that don't know, a scrub cap is that "hat" most surgeon's wear in the operating room. For me as part of my operating room style, I like to wear colorful scrub caps with college football logos on them. He likes the maroon/red color as it reminds him of his native Cuba. He also requested a New York Yankees scrub cap because of C.C. Sabatha. I quickly let him know that as a Philly boy, C.C. Sabatha was washed up, needed to lose about 20 and those songs about New York from Sinatra to Jay-Z and Alicia Keys stink. Oh yeah Mr. Roland, the Yanks will have to see the Phils again. We got a quick laugh and I promised once again that I would give him my information for future contact and grant him his Fla. St. scrub cap wish.I will leave him with Tennesee, Duke, and Michigan State.

Enough kidding around!! Today God demonstrated to me just how great a force he is. Discouragement and disappointment has now turned to elation and excitement. For you see today WE WON the RACE. We met a team from Illinois and the tri-state plus region (Philly, Jersey and B'more).They had two anesthesiologists with medications and the desire to provide assistance in getting us up and running. Let me tell you, they were a godsend. The Philly raised anesthesiologist fixed the broken anesthesia machine in the swaying operating room. New York?? One word, Philly!


This is the generator that gives us a power supply.
The Canadian Army continues to supply us with diesel fuel.

She and Dr. Brebbia found that there was a leak in one of the circuits. She is a Colonel in the US Army. She made a few calls and in about an hour she had the machine in our tent and ready to provide anesthesia. A victory indeed. Next, the Canadian forces that had been so gracious to us rode in like the calvary and provided us with over 40 gallons of diesel fuel to power our generator. Last problem was solved by one of the Haitian physicians. Her father was an electrician on site. With his experienced hands he made our generator operational and fed power into our field operating room. One of our translators provided us with cords for lights, a fan and he went out and brought us an air conditioner back to cool our tent. Incredible to say the least. A page from MacGyver. I am proud to say that our operating room is fully functional and I performed the first real operation today.

With my other surgical coleagues we have done five cases for the day and have had great results. First, was little 4 year old Louis (Lu-eee). He had a cut to the undersurface of his chin during the quake and now had an abscess. I drained his abscess and as he hugged me goodbye he changed my life forever. I hope to see him again before I leave Haiti. He must fight all odds to survive in his poverty stricken nation. His follow up is on Monday. The others faired well including a man who needed a hernia repair. He was doing well when I left this evening at 630PM. In addition, I also rounded with the Cubans and the Haitians and saw all of the patients on the ward to look at all wounds and schedule surgeries for tomorrow. I find that WE as a team are gaining trust with our multinational colleagues. They now have a different perception of Americans without a doubt.Even with the Cubans and Haitians flying their rrespective flags on the tents I have that our team put a banner with the title OR 7... Haiti, Cuba, Canada, US". Wr hope to make a point without pounding our chests.

Our Father in Heaven NEVER let's us down. He only tests us to see if our faith will be everlasting and durable. Today was an affirmation of this FACT.

WE are clearly making a difference. Tonight as I walk back to the compound where we are staying, my colleagues who are not surgeons have made a clinic with babies, adolescents and adults lining the streets seeking medical attention. Our supplies are strong, the people are determined to move on with their lives and I am proud of our efforts to make something out of NOTHING.

AND THEN THERE WAS LIGHT!!

- Doc J.

The Comment section is Now

finally working. Just click the comments link at the end of each post and choose the anonymous option. HOWEVER, be sure to include your name and info as Steve would like to know who you are. Sorry about this feature not being available earlier.

(-Admin - Antar Johnson) 

Friday, January 22, 2010

Slow and Steady Wins the Race

Good evening,

Let me begin by saying that today was a grueling, challenging day for the team. We started early this AM with breakfast prepared by our gracious hosts. The time keeper woke us up some 1.5 hrs before we were supposed to move out!! Killing me but we laughed about it. Our journey here was brutal, leaving us drained and in need of rest.

Good News!!!! The remainder of our team arrived today along with all of our equipment and meds!!!! They survived the night in Cabo Rojo by being treated nicely by the bus service employees that drove us from Santo Domingo.

Several hundred pounds of instruments, food, water and medications were loaded onto trucks and brought to our so-called "command post" in town. The three native individuals who are part of our mission skillfully negotiated each day in their French and Creole languages. Creole has a remarkably melodic sound and makes me want to learn more about its origins from the French occupation of many African nations (during the slave trade). Even more, many of the patients encourage me to learn the language as I respond to them in English and very poor French.

I find the Haitian people to be extraordinarily resilient and spiritual. Catholicism and voodoo are practiced here and this is what is getting them through their times of dire straits. They sing daily with determination and an ardent desire TO LIVE.

Let me see. First, we went to the only public hospital in Jacmel. Dr. Brebbia, Dr. Agard, and myself met with the medical director today. In all honesty, I felt like he was shaking his head without understanding us. More accurately he was filled with a tremendous amount of bureaucracy and he cares a lot about how he is perceived. But who are we to criticize? We are visitors to his country. With much negotiating, however, we were able to be granted permission to practice at the hospital.

Next hurdle was trying to join forces with the Cuban and Haitian physicians already practicing. Despite initial resentment and stare downs from "El Jefe"- a rather heavy set man who refused initially to talk to us in Spanish or English, quickly warmed up to us. I thought quickly of talking about baseball and his pitching ability. Our rapport and bond despite living worlds apart has grown incredibly strong. Medicine is the universal language right now. In fact, I feel like we are trusted even more because I kept a promise to Rolando, a proud Cuban anesthesiologist who is running out of anesthetic agents. And I quote, "your people" show up and DO NOTHING".

Later on I found out that 2 American teams showed up a few days before and did not provide any support. In stark contrast our team showed up with so many supplies and medications, along with food and water that Roland, Daniel and all of the 23 Cubans are now handing out hugs every time we see them (well not all of them). Instead, I offer up hand shakes. Especially in light of the fact that Roland sweats a lot. LOL!!

Putting all political differences aside and recognizing the strength of joint collaboration is paramount to our success and sustainment in this region. We are on a mission to save lives.

Next, was the biggest struggle of the day. The picture that Antar Johnson posted on the blog page has a caption that talks about a home being destroyed. That pic is actually a major section of the hospital right next to the OR(operating room). The OR has been abandoned because the actual OR room sways during the aftershocks that have occurred. The natives REFUSE to go in there and the Cuban surgeons strongly feel it is an unsafe place to be while operating. You don't have to tell me once. I can see that the building has structural damage and the potential for collapse. I would NEVER sacrifice anyone's safety or my own safety in this situation (I contemplated it for 30 seconds). We would clearly be trapped if collapse occurred...for good in most cases. I admit that I was stupid today as I walked in with a Canadian engineer to assess the operating room table and lights. The anesthesia machine unfortunately does not work.

Setting up a portable OR outside (where there are unsteady structures) was a challenge. Today we found a site and we had to problem solve. How can you make the operating room functional? My answer along with the other team members was to find a tent and move all of the equipment (OR table, anesthesia machine, lights, medicines). Not your ordinary tent by the way. Instead, a mod unit that looks very similar to those used in Korea and Vietnam to establish "field hospitals".

We were resourceful today. We spoke with UN forces from Sri Lanka and they gave us transportation to the docks. There stood Major Bouchard, the commanding officer of the Canadian military medical corps. She was not only a strong female role model, but she was sharper than a Ginsu knife with a sprinkle of compassion like Mother Teresa. She understood our resentment of all the "red tape" and helped us to get a much needed win for the day. She granted us the field tent, had her engineers survey the land and the surrounding buildings (inclusive of a damaged water tower) to ensure our safety, and is providing diesel fuel for a generator tomorrow. Furthermore, Canadian forces went into the dilapidated building and pulled out ALL the OR equipment putting it under the tent.

Starting tomorrow AM I hope to be doing some operating room cases to clean up wounds and address soft tissue injuries.

A little girl some 9 years of age was screaming at the top of her lungs because two of her fingers had been amputated during the initial quake. Doctors from Fairfax, VA were doing dressing changes. Needless to say, it was a blood kurdling experience for everyone. Her cries are representive of all of Haiti right now.

We have made calls home for an anesthesiologist and an orthopedic surgeon as many fractured bones need fixation.

What a whirlwind!!!

In closing, there are dead bodies piling up, red tape in a third world country is paralyzing, there is no one taking the lead with coordination, crooked officials appear to care very little about their people and we are fighting against all odds. We plan on a full day tomorrow. God help us.

Slow and Steady Wins the Race- at least that's what I keep telling myself.


Respectfully,

Steven A. Johnson

Pics By Doc J

In order to preserve all intellectual property rights from Photographers/Press or Dr. S. A. Johnson. DO NOT COPY or repost picture from this blog/website without the express written permission.
Upon arriving Doc J took this picture of a family home that was destroyed. However, after looking around a bit more saw that this was just one of many homes that were destroyed by the earthquakes.[Update: Found out that was part of the Hospital not a Home. Thanks for the correction Steve. - Antar] He also added that he is truly part of an international relief effort. He has teamed up with some Cuban Doctors who are also there to help.

Many dead bodies lie in this rubble.

Pics by Doc J



In order to preserve all intellectual property rights from Photographers/Press or Dr. S. A. Johnson. DO NOT COPY or repost picture from this blog/website without the express written permission.



Doc J asked me to post one of several pics he took yesterday while traveling with his team on the boat. This one is of a unharmed portion Haiti's coastline.


There are dogs everywhere. 



Thursday, January 21, 2010

The Going Gets TOUGH


Good afternoon all:

After 3 and a half hours by air into Santo Domingo, the Dominican Republic, 6 hours by bus to Cabo Rojo, a border town to Haiti, our deployment team of 22 has safely made it to the point of no return. We prayed for a safe journey and it has been exactly that. The arrival at the airport in the DR was seamless and we had prearranged transport with food and all of our medical equipment and supplies. The DR has beautiful people who are. Willing and currently lending a helpful hand. What was interesting was the ride through the Dominican highways and countryside. We stopped several times for water and conversation with the locals. They wished us luck at a time like this giving a testament to the human condition and the spirit of giving.

I must admit that it has been a bit rough sitting on a bus for some 6 hours after getting off the plane. Oh yeah the two young women that I referred to before talked the whole way so I tried to act like I was asleep for the larger part of the journey. LOL!!

Once at this border town, we have now had to make a difficult decision. The DR coast guard had us prepare all of our belongings for boarding their cutter only to get word from their boss that we could not carry all of the gear due to weight restrictions (both people and goods). As a result he only gave us two choices.
Either leave 10 people behind with the supplies and our personal belongings or board all 22 team members and leave ALL of our supplies. Dr. Ray Agard (Internal Medicine) and myself have been made the team leaders and we met aboard the CG cutter and basically had verbal judo with the Captain via one of our nurse translators. The compromise and my decision was to leave our medical supplies, food, some of our tents, sleeping bags, and other personal luggage behind along with 5 of the team members (inclusive of my colleague Dr.Agard). Please understand that I have an empty feeling right now as I violated one of my rules as a trauma team leader. NEVER leave a member of your strike team behind and I'm the first one in and the last one out". Dr. Agard pointed out the fact that this was going to be a tough decision as this would result in our equipment and personal items being left on the dock with he and four others to keep an eye on it. The Captain was "gracious" enough to ensure the baggage will be picked up tonight at 10p.m. along with my remaining colleagues. Their arrival will be at 6:30a.m. tomorrow morning. I am left with Ray's wife and the remaining team members as the Team Leader. But I will rise to the challenge!!

We are currently on the CG cutter traveling at such a slow rate that a mere one hour trip at high speed will take some 5 hours more as we crawl towards Jacmel, Haiti. We were granted one "carry-on" bag and I instructed all to ensure security of their passports, toothbrushes, a change of undergarments, mosquito repellent, sunglasses, as much water and fruit that they could carry and board! We are undoubtedly in for a rough night!! We will not turn back now though. I am hopeful and everyone's determination is admirable. We have two national guardsman, a Haitian police officer and UN forcve presence awaiting us. In addition, several of my passengers speak both French and Creole, and are native to this region of Haiti.

As an aside, my discussion with the Governor of Santo Domingo was a very encouraging one. Jacmel and six surrounding cities have an immediate need for general/trauma surgeons, orthopedic surgeons and pediatricians. Dr. Agard and I earlier assured him that we are ready.


Please spread this blog to many others. Antar, I would like to add my wife and her friends. I am not going to include my work colleagues as we have a journalist providing Twitter chat.

To my lovely wife and children... I love you from here to the Moon and back. I have your recorded voices keeping me focused for the major UNKNOWN we soon face. Pray for us. We will succeed. I am trying to conserve my batteries so I may not respond right away and electricity is gold around here. Talk to you all soon.

-Doc J

Update : Doc J called me 1/20

and informed me that due to yesterday's aftershocks his sleeping arraingements have been compromised. He is currently in a tent. God be with you Nupe. You are defintely out there doing the Lord's work! (-Admin, Antar Johnson)

Wednesday, January 20, 2010

Doc J was featured on


the evening edition of ABC News 1-20-10 local affilliate in Philly. I will try to find links to the interview and post them. Until then below is a link to an article and picture from with Delawareonline.com about the group of Doctors headed to Haiti.(-Admin, Antar Johnson)
http://www.delawareonline.com/article/20100121/NEWS02/1210353/1006/NEWS

The Departure

Well the time has come for departure. Met a team from Vermont who are search and recovery experts.Sitting between two young, attractive young women from Santo Domingo, D.R. And Philly. Unfortunately, I'm tired, and they won't be quiet. They are talking non-stop and I'm thinking about telling them to be quiet. LOL!! Anyway my destination is Santo Domingo with a bus ride to the southern shore of the DR. There a coast guard cutter will be picking us up to take us into Jacmel, Haiti.

-Doc J

The Beginning



This blog is created so that Trauma Surgeon, Steve Johnson can memorialize his experiences while volunteering to help in Haitian earthquake relief efforts. Dr. Johnson arrived on January 20, 2010 and only has access to his cellphone but he will attempt to relay what he is experiencing in Port-au-Prince  and other parts of Haiti.
[Admin- Antar Johnson]